NPIMap

Organization Active NPI

Kucinski Medical LTD

  • Internal Medicine Physician
  • Morris, IL
National Provider Identifier
1376896506
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036131189 Issued in IL
Legal business name
KUCINSKI MEDICAL LTD
Practice address
114 W Waverly St
Morris, IL 60450-1422
Phone
(815) 941-8210
Fax
(815) 941-1584
NPI assigned
Oct 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Laura Jean Kucinski, D.O.
Title
President
Phone
(815) 942-8210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036131189 IL Primary

Addresses

Primary practice location

114 W Waverly St
Morris, IL 60450-1422

Mailing address

114 W Waverly St
Morris, IL 60450-1422
Phone (815) 941-8210

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1376896506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W WAVERLY ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501422",
            "telephone_number": "815-941-8210",
            "fax_number": "815-941-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W WAVERLY ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501422",
            "telephone_number": "815-941-8210",
            "fax_number": "815-941-1584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUCINSKI MEDICAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "KUCINSKI",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-942-8210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036131189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.